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NPI Code Detail

MEDICARE: MR. JOHN ROBERT JOHNSON CRNA

MEDICARE: MR. JOHN ROBERT JOHNSON CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistRN140884OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1430062329OTHERMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2000000187654OTHERANTHEM
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487605283
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN ROBERT JOHNSON CRNA
Provider Business Mailing Address
First Line : PO BOX 14806
Second Line :
City : COLUMBUS
State : OH
Zip : 43214-0806
Country : US
Telephone Number : 614-261-3723
Fax Number : 614-447-9593
Provider Business Practice Location Address
First Line : 3300 WELTY RD
Second Line :
City : LUCAS
State : OH
Zip : 44843-9729
Country : US
Telephone Number : 419-566-4152
Fax Number : 419-842-3875
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2006
Last Update Date : 07/30/2013

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